Notes

Links among phasic excitement along with decisions below risk in young and older adults.
The purpose of this review is to give an update on chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).

There are several recent developments in CIDP, the major one being the 2021 second revision of the European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy. Other updates address therapy in CIDP, antibodies, serum neurofilament light chain, chronic immune sensory polyradiculopathy (CISP) and CIDP mimics.

CIDP criteria continue to be refined and some disorders are now excluded from the classification. Treatment options are expending and promising biomarkers are being studied.
CIDP criteria continue to be refined and some disorders are now excluded from the classification. Treatment options are expending and promising biomarkers are being studied.
Neuroimaging is often part of the workup for a pediatric patient presenting with a seizure to an emergency department (ED). We aim to evaluate when neuroimaging in the ED for children with a non-first-time seizure, or nonindex seizure (NIS), is associated with an acute change in management (ACM).

This is a retrospective cohort study of all pediatric patients presenting to an ED from 2008 to 2018 with a NIS, excluding repeat febrile seizures, who underwent neuroimaging. Clinical characteristics were extracted from the electronic medical record. The primary outcome was new abnormal neuroimaging resulting in an ACM, defined as admission to the hospital, neurosurgical intervention, or new nonseizure medication administration.

We identified 492 encounters. Neuroimaging revealed new findings in 21% of encounters and led to ACMs in 5% of encounters. ACMs included admissions, neurosurgical interventions, and nonseizure medication changes. Factors associated with ACM included new seizure type (odds ratio [OR] 3.e utilization are critically important.
Muscle-specific kinase (MuSK) antibody-positive myasthenia gravis (MuSK + MG) is a form of MG with bulbar-predominant symptoms often resistant to conventional treatments. Patients with MuSK + MG may have an electrodiagnostic (EDX) profile distinct from other MG. This study compares EDX features of MuSK + MG with acetylcholine receptor (AChR) antibody-positive MG (AChR + MG) to discern whether any unique EDX pattern exists that can aid in clinical diagnosis.

From January 1, 2010, through December 31, 2020, all patients with MuSK + MG at our institution were identified and randomly matched to an AChR + MG cohort in a 12 ratio based on sex, age at onset, and subsequently Myasthenia Gravis Foundation of America (MGFA) clinical severity for a case-control study. Each patient's clinical profile, treatment, and EDX testing were summarized and analyzed.

Twenty-two patients with MuSK + MG (18 female) and 44 patients with AChR + MG were studied. The average symptom duration at presentation was shorter in the MuSK + MG group (4.7 years) compared with AChR + MG (10.9 years). Myotonic discharges were rare in both groups but more frequently observed in patients with MuSK + MG (10%) identified in 5 muscles in 2 patients compared with AChR + MG (2%) noted in only 1 muscle in 1 patient. Patients with MuSK + MG more often had myopathic appearing motor unit potentials (MUPs) (41% vs 30%) compared with AChR + MG. Myopathic appearing MUPs were found in milder cases of MuSK + MG (MGFA class I-IIB) compared with AChR + MG (MGFA Class IIB-V).

Patients with MuSK + MG may have a recognizable EDX profile from AchR + MG that includes (1) myotonic discharges, (2) greater occurrence of myopathic appearing MUPs in clinically mild disease, and (3) symptoms leading to earlier testing.
Patients with MuSK + MG may have a recognizable EDX profile from AchR + MG that includes (1) myotonic discharges, (2) greater occurrence of myopathic appearing MUPs in clinically mild disease, and (3) symptoms leading to earlier testing.
Delays in access to neurologic care are a major problem. In this pilot program, we aimed to evaluate the effectiveness of a novel staffing model for neurology outpatient clinic within an academic neurology center to increase access to neurologic care, while incorporating such a model into a growing academic neurology department.

We created a new model for provision of access to neurologic care that could be introduced in an academic neurologic department, the access clinic. One attending was assigned to staff the access clinic for 1 week at a time. This was introduced as rotation equal to conventional on-service inpatient rotations. Descriptive analyses were performed to characterize the access clinic's performance characteristics. Comparisons were made to the previously established traditional faculty clinic model.

A total of 5,917 access clinic visits were compared with 6,000 traditional clinic visits. Lead time dropped from 142 to 18 days for new patients and from 64 to 0 days for return visits. Although total readmission rates were similar during both clinic periods, readmission through the emergency department was less for access clinic patients. The access clinic resulted in significant improvement in patient satisfaction ratings. The access clinic model was financially profitable.

Our findings suggest that introducing an access clinic as service rotation for neurology faculty is both effective in offering enhanced access for patients to neurologic care and for patient satisfaction. Future studies may test this model in other centers and should address the effect on provider satisfaction.
Our findings suggest that introducing an access clinic as service rotation for neurology faculty is both effective in offering enhanced access for patients to neurologic care and for patient satisfaction. Future studies may test this model in other centers and should address the effect on provider satisfaction.Periodontal and chronic oral mucosal diseases are significant life impacting conditions which may co-exist and synergistically act to cause more severe and widespread oral pathology with enhanced challenges in effective management. Clinicians regularly observe these effects and struggle to effectively manage both problems in many patients. There is limited understanding of many basic and applied scientific elements underpinning potentially shared aetiopathological features and management. Recent developments in translational science provide an opportunity to greater improve knowledge and subsequently care for patients with these problems.Ferroelectric barium titanate (BTO) powder particles were encapsulated by three different sizes of reduced graphene oxide (rGO) platelets. The size of the graphene oxide (GO) platelets is controlled by varying the horn type ultrasonic times, i.e. 0, 30, and 60 min, respectively, and they are reduced with hydrazine to obtain rGO-encapsulated BTO (rGO@BTO) film. The rGO@BTO film exhibits an increase in the dielectric characteristics due to the interfacial polarization. These improved characteristics include a dielectric constant of 194 (a large increment of 111%), along with the dielectric loss of 0.053 (a slight increment of 13%) at 1 kHz, compared to the pure BTO dielectric film. The improvement in the dielectric constant of the rGO@BTO is attributed to the encapsulation degree between the rGO platelets and BTO powder particles, which results in the interfacial polarization and micro-capacitor effect in a dielectric film, and also contributes to a low dielectric loss. Therefore, a suitable size of rGO platelets for encapsulation is essential for high-dielectric performance.Existing lithium-ion-conducting covalent organic frameworks (COFs) are mainly two-dimensional, in which the one-dimensional channels are difficult to completely and uniformly stack in the same direction, particularly in the case of powdered COFs, resulting in the hindrance of ion transport at the grain boundary or at the interface of the powder contact. In this contribution, poly(ethylene glycol) (PEG)-functionalized three-dimensional COFs with 3D channels were successfully constructed for ion conduction in different directions, which is conducive to reducing the grain boundary and interface contact resistance. Combined with the coupling behaviour between the PEG chain segments and Li-ions, the 3D COF incorporated with LiTFSI achieves a high ionic conductivity of 3.6 × 10-4 S cm-1 at 260 °C. The maximum operating temperature is higher than the boiling point of commercial organic electrolytes, indicating the excellent security of PEG-based COFs as Li-ion polyelectrolytes at high temperature.Titanium oxide (TiO2) has been widely investigated as a photocatalytic material, and the fact that its performance depends on its crystalline structure motivates further research on the relationship between preparation methods and material properties. In this work, TiO2 thin films were grown on non-functionalized wave-like patterned vertically aligned carbon nanotubes (w-VA-CNTs) via the atomic layer deposition (ALD) technique. see more Grazing incidence X-ray diffraction (GIXRD) analysis revealed that the structure of the TiO2/VA-CNT nanocomposites varied from amorphous to a crystalline phase with increasing deposition temperature, suggesting a "critical deposition temperature" for the anatase crystalline phase formation. On the other hand, scanning transmission electron microscopy (STEM) studies revealed that the non-functionalized carbon nanotubes were conformally and homogeneously coated with TiO2, forming a nanocomposite while preserving the morphology of the nanotubes. X-ray photoelectron spectroscopy (XPS) provided information about the surface chemistry and stoichiometry of TiO2. The photodegradation experiments under ultraviolet (UV) light on a model pollutant (Rhodamine B, RhB) revealed that the nanocomposite comprised of anatase crystalline TiO2 grown at 200 °C (11.2 nm thickness) presented the highest degradation efficiency viz 55% with an illumination time of 240 min. Furthermore, its recyclability was also demonstrated for multiple cycles, showing good recovery and potential for practical applications.COVID-19 persists as the most challenging pandemic of the 21st century with a high rate of transmission. The main pathway of SARS-CoV-2 transmission is aerosol-mediated infection transfer through virus-laden droplets that are expelled by infected people, whereas indirect transmission occurs when contact is made with a contaminated surface. This mini review delivers an overview of the current state of knowledge, research directions, and applications by examining the most recent developments in antiviral surface coatings and filters and analyzing their efficiencies. Reusable masks and other personal protective devices with antiviral properties and self-decontamination could be valuable tools in the fight against viral spread. Moreover, antiviral surface coatings that repel pathogens by preventing adhesion or neutralize pathogens with self-sanitizing ability are assumed to be the most desirable for terminating indirect transmission of viruses. Although many nanomaterials have shown high antiviral capacities, additional research is unquestionably required to develop next-generation antiviral agents with unique characteristics to face future viral outbreaks.
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